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Objective: Many arthritic patients have the belief that dietary habits can worsen or ameliorate their symptoms. Whether diet quality can modify the risk of rheumatoid arthritis (RA) is an issue of continued scientific debate and interest. Therefore, we aimed to examine the association between both overall diet quality and the overall diet inflammatory potential on the risk of RA. Design: Overall diet quality and the overall inflammatory potential of the diet were evaluated with the use of Dietary Inflammatory Index (DII) and the Healthy Eating Index (HEI)-2015, respectively. Both DII and HEI-2015 scores were calculated based on a validated semi-quantitative Food Frequency Questionnaire (FFQ). Multivariable-adjusted odds of RA were calculated across tertiles of HEI, and Energy-adjusted DII (E-DII) scores using binary logistic regression. Setting: Mashhad, Iran Participants: 50 newly diagnosed RA cases and 100 well-matched healthy people controls. Results: Individuals in the highest tertile of DII scores, indicating the most pro-inflammatory diet, were about three times more likely to have RA than those in the lowest tertile (Odds Ratio: 2.99; 95%CI: 1.08 to 8.24; P-trend:0.037), whereas individuals in the highest tertile of HEI scores, indicating more top dietary quality, had a significantly lower odds of RA than those in the lowest tertile (Odds Ratio: 0.33; 95%CI: 0.12 to 0.87; P-trend:0.024). Conclusion: Our findings show that E-DII and HEI-2015 are positively and negatively associated, respectively, with the odds of RA in a convenience sample of Iranians. These results highlight the importance of overall diet quality in modulating the risk of RA.

Rheumatoid arthritis (RA) is a chronic autoimmune disease in which inflammation and oxidative stress play a key role in its pathophysiology. Complementary therapies along with medications may be effective in the control of RA. Propolis is a natural substance extracted from beehives, which have confirmed anti‐inflammatory and antioxidant effects. The present study aimed to review the possible effects of propolis on inflammation, oxidative stress, and lipid profile in patients with RA. English articles in online databases such as PubMed‑Medline, AMED, Google Scholar, EMBASE, Scopus, and Web of Science databases were searched. Pieces of evidence show that supplementation with propolis may have therapeutic effects on RA patients. Due to increased inflammation and oxidative stress in the affected joints of RA patients, propolis could inhibit the inflammatory cascades by inhibiting the nuclear factor kappa B pathway and reducing reactive oxygen species, malondialdehyde, and interleukin‐17 by increasing some antioxidants. Therefore, inflammation and pain reduce, helping improve and control RA in patients. Further investigations are required with larger sample sizes and different doses of propolis to demonstrate the definite effects of propolis on various aspects of RA.

Inflammatory rheumatic diseases are a heterogeneous class of often chronic autoimmune disorders. They are among the most common chronic diseases. They cause major health problems in the general population. This study assessed the distribution of inflammatory systemic rheumatic diseases in a rheumatologic outpatient clinic. The medical records of patients diagnosed with any type of inflammatory rheumatic disease between January 1, 2006 and December 31, 2016 in a non-hospital-based rheumatologic outpatient practice in Mashhad, Iran were retrospectively studied. Diagnoses were made using the agreed-upon classification criteria. Data regarding each patient's diagnosis, age at onset of disease, and gender was extracted from their files. The total number of patients was 12,626. The most common diseases were rheumatoid arthritis (47.30%), spondyloarthropathies (17.23%), systemic lupus erythematosus (8.10%), gout (7.84%), and vasculitis (6.84%). Patients were aged from 1 to 93 years, with a mean age of 41.17±39.70 years. Most patients were in the third, fourth, and fifth decade of life. Sixty-four percent of all patients were female. The overall sex ratio (women to men) was 1.8:1. The proportion of women was 95% in Takayasu's arteritis, 92% in systemic lupus erythematosus, 87% in Sjögren's syndrome, 78% in rheumatoid arthritis, and 24% in ankylosing spondylitis. The age at onset of inflammatory rheumatic diseases in Mashhad, Iran is lower than that in some other regions. The frequency of Behcet's disease, systemic lupus erythematosus, and systemic sclerosis was greater in this study than in most other studies, but gout, polymyalgia rheumatica, and psoriatic arthritis were less frequent in the current study.

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